慢性牙周炎患者血清NfL以及HE4的表达与诊断价值研究

Study on the expression and diagnostic value of serum NfL and HE4 in patients with chronic periodontitis

目的:探究慢性牙周炎(chronic periodontitis,CP)患者血清神经丝轻链(neurofilament light chain,NfL),附睾蛋白4(human epididymal protein 4,HE4)的表达与诊断价值。方法:选择2022年1月~2024年2月在本院诊治的51例CP患者,同期体检的健康志愿者51例为对照组。ELISA检测炎症因子肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-6(interleukin-6,IL-6)、C反应蛋白(C-reactive protein,CRP)、IL-1β以及NfL、HE4水平。检测免疫球蛋白A(immunoglobulin A,IgA)、IgM、IgG水平。检查并记录牙周临床指标探诊深度(probing depth,PD)、附着丧失(loss of attachment,AL)、龈沟出血指数(gingival sulcus bleeding index,SBI)、牙龈指数(gingival index,GI)。Pearson相关性分析NfL、HE4水平与实验室指标以及牙周临床指标(PD、AL、SBI、GI)之间的相关性;多因素Logistic回归分析CP发生的影响因素;ROC曲线分析NfL、HE4对CP发生的诊断价值。结果:CP组牙龈出血、牙面菌斑例数、免疫因子IgG,炎症因子IL-6、IL-1β、CRP、TNF-α,牙周临床指标GI、SBI、PD、AL以及血清NfL,HE4水平高于对照组(P<0.05);血清NfL,HE4水平与免疫因子IgG,炎症因子IL-6、IL-1β、CRP、TNF-α,牙周临床指标GI、SBI、PD、AL均呈正相关(P<0.05);存在龈下菌斑以及血清NfL,HE4水平升高是CP发生的独立危险因素(P<0.05);NFL、HE4单独诊断CP发生的AUC分别为0.830、0.821,联合诊断的AUC为0.908,优于各自单独诊断(均P<0.05)。结论:CP患者NfL,HE4水平升高,并与牙周临床指标、免疫因子、炎症因子指标呈正相关,两者联合诊断CP发生具有一定的临床意义。

Objective:To investigate the expression and diagnostic value of serum neurofilament light chain(NfL)and human epididymal protein 4(HE4)in patients with chronic periodontitis(CP).Methods:This study selected 51 CP patients who were treated in our hospital from January 2022 to February 2024,and another 51 healthy volunteers who underwent physical examinations were selected as the control group.ELISA was applied to detect levels of inflammatory factors such as tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP),IL-1β,NfL and HE4.The levels of immunoglobulin A(IgA),IgM and IgG were detected.Clinical indicators of periodontal disease,including probing depth(PD),loss of attachment(AL),gingival sulcus bleeding index(SBI)and gingival index(GI)were examined and recorded.Pearson correlation was applied to analyze the correlation between NfL,HE4 levels and laboratory indicators,periodontal clinical indicators(PD,AL,SBI and GI).Multivariate logistic regression was applied to analyze the influencing factors of CP occurrence.ROC curve was applied to analyze the diagnostic value of NfL and HE4 in the occurrence of CP.Results:The gingival bleeding,number of dental plaque cases,immune factor IgG,the inflammatory factors IL-6,IL-1β,CRP,TNF-α,the periodontal clinical indicators GI,SBI,PD,AL,and serum NfL,and the HE4 level in CP group were higher than those in control group(P<0.05).Serum NfL and HE4 levels were positively correlated with immune factors IgG,inflammatory factors IL-6,IL-1β,CRP,TNF-α,and periodontal clinical indicators GI,SBI,PD and AL(P<0.05).The presence of subgingival plaque and elevated serum NfL and HE4 levels were independent risk factors for CP occurrence(P<0.05).The AUC of NfL and HE4 in diagnosing CP was 0.830 and 0.821,respectively,while the AUC of combined diagnosis was 0.908,which was better than their individual diagnoses(P<0.05).Conclusion:The levels of NfL and HE4 in CP patients increase and they are positively correlated with periodontal clinical indicators,immune factors and inflammatory factors.The combination of the two has certain clinical significance in diagnosing the occurrence of CP.